Low Back Pain pic2Low Back Pain:

What Patients Need to Know

Low back pain is one of the most common conditions in the US., affecting approximately 80% of adults. Low back pain ranges in intensity, frequency and duration, and may include leg pain and other symptoms as well.

Types of Low Back Pain

Axial low back pain, the most common type of back pain, is confined to the lower back only and does not travel into the buttocks or legs. The pain usually worsens with certain activities (such as sports) or physical positions (such as sitting for long periods) and is relieved by rest.

Lumbar radiculopathy (sciatica) is the second most common type of back pain. Caused by conditions that compress the nerve roots of the sciatic nerve, the pain is frequently more severe in the leg than in the back. Pain or weakness is only felt on one side and can affect the buttock, leg and foot.

Low back pain with referred pain is pain in the lower back that also radiates to the groin, buttock and upper thigh, but rarely below the knee. Patients describe the pain as dull and achy, often deep inside the leg with varying intensities. Low back pain with referred pain is similar to axial pain, but often includes leg symptoms.

Common Causes and Symptoms of Low Back Pain

  •  Muscle and ligament strains and sprains: Lifting a heavy object, twisting, or a sudden movement can use muscles or ligaments to stretch or tear. The pain is usually localized (axial) and can be so severe that the patient  is unable to walk or stand.
  •  Lumbar disc herniation: A herniated disc in the lower spine puts direct  pressure on the nerve roots that make up the sciatic nerve, causing pain to  radiate into the buttocks, leg and foot (sciatica).
  • Degenerative disc disease: Even in young adults, spinal discs may begin to degenerate. While some people never feel symptoms, others experience chronic: fluctuating low back pain that worsens with certain positions or activities.
  • Osteoarthritis: Facet joint osteoarthritis is a gradual breakdown of the cartilage that serves as a cushion between the facet joints in the spine. Friction between the facet joints causes inflammation, triggering pain and stiffness.
  • Spinal stenosis: Some conditions, including facet joint osteoarthritis, cause bone spurs to form on the facet joints. When the bone spurs press on the sciatic nerve roots, they cause pain and numbness that can affect the buttocks, leg and foot.

Treatment Options for Low Back Pain

Treatment for lower back pain depends upon the patient’s history and the type and severity of pain. The vast majority of lower back pain cases get better within six weeks and with nonsurgical treatment.


Resting for 1 to 2 days allows injured muscles, ligaments and even nerve roots to begin healing. However, rest for more than a few days can lead to muscle atrophy, which can worsen low back pain because the weakened muscles do not adequately support the spine.


Heat and ice packs help relieve most types of low back pain, particularly in more acute cases. Usually ice or heat is applied for approximately 20 minutes and repeated every 1 -2 hours. Most people use ice first, but some people find more relief with heat. The two may be alternated which functions like a “pump” to remove swelling.


Over-the-counter or prescription medications may be helpful in relief of lower back pain. Non-steroidal anti-inflammatory drugs {NSAIDs) or oral steroids reduce inflammation, which is often a cause of pain.

Chiropractic Manipulation

Chiropractic manual manipulation focuses on improving spinal function to increase spinal range of motion, decrease pain and inflammation, and improve overall physical functioning.

  • Chiropractic manipulation typically involves a controlled, sudden force applied to a spinal segment to normalize motion and improve function. Adjustments may be performed using high-velocity or low-velocity techniques.
  • Reducing joint restriction and restoring function allows the local inflammation and pain reflex responses to begin to subside.
  • In some cases, an accompanying, audible release of gas (joint cavitation or cracking) that is caused by the release of oxygen, nitrogen, and carbon dioxide, may be heard. This is a phenomenon and has no known physiological effect, but signifies that pressure was released from the joint.
  • A relieving sensation is usually perceived. Less frequently, minor discomfort may occur (that usually resolves within a few hours) if the surrounding muscles are in spasm or tense.

Physical Therapy, Exercise and Stretching

A central component of almost any lower back pain treatment plan includes aerobic conditioning, stretching and strengthening, which builds stronger support for the spine to help prevent future episodes of back pain.

Other Possible Treatments

Other forms of therapies including ultrasound, electrotherapy/TENS, acupuncture, various forms of traction, massage therapy and other techniques may be utilized depending on the practitioners training and the specific cause of the low back pain.

If you experience low back pain in Asheville, call our office at 828-209-1900.